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25C-252 (9) 37 FAIR ST BP-2018-1070 GIs#: COMMONWEALTH OF MASSACHUSETTS Mao:Block:25C-252 CITY OF NORTHAMPTON Lot:-001 PERSONS CONTRACTING WITH UNREGISTERED CONTRACTORS Permit: Building DO NOT HAVE ACCESS TO THE GUARANTY FUND (MGL c.142A) Catcgmv:renovation BUILDING PERMIT Permit# BP-2018-1070 Proiect# JS-2018-001933 Est. Cost:$45460.00 Fec: $295.00 PERMISSION IS HEREBY GRANTED TO: Const.Class: Contractor: License: Use Group: CARLWOODRUFF 109983 Lot Size(so. ft.): 21170.16 Owner: KARNEY STEPHEN Zoning: SC(100)/ Applicant: CARL WOODRUFF AT. 37 FAIR ST Applicant Address: Phone: Insurance: 30 PAVE ST 2ND FLOOR (315) 854-4024 WC EASTHAMPTONMA01027 ISSUED ON:4/19/2018 0:00.00 TO PERFORM THE FOLLOWING WORK:REMODEL MASTER BATHROOM, REPLACEMENT OF FRONT DOOR, 2 ATTIC WINDOWS & NEW SIDING POST THIS CARD SO IT IS VISIBLE FROM THE STREET Inspectorof Plumbing Inspector of Wiring D.P.W. Building Inspector Underground: Service: Meter: Footings: Rough: Rough: House# Foundation: Driveway Final: Final: Final: Rough Frame: Gas: Fire Department Fireplace/Chimney: Rough: Oil: Insulation: Final: Smoke: Final: THIS PERMIT MAY BE REVOKED BY THE CITY OF NORTHAMPTON UPON VIOLATION OF ANY OF ITS RULES AND REGULATIONS. Certificate of Occupancy Shmalure: FeeTvoe: Date Paid: Amount: Building 4/19/20180:00:00 $295.00 212 Main Street,Phone(413)587-1240,Fax:(413)587-1272 Louis Hasbrouck—Building Commissioner Department use only City of Northampton Status of Permit: .r" Building Department Curb Cul/Driveway Permit 212 Main Street Sewerfseptic Availabiliry _ Room 100 WaterM/ell Availability Northampton, MA 01060 Two Sets of Structural Plans phone 413-587-1240 Fax 413-587-1272 Plotlsile Plans Other Specify APPLICATION TO CONSTRUCT,ALTER,REPAIR, RENOVATE OR DEMOLISH A ONE OR TWO FAMILY DWELLING SECTION t -SITE INFORMATION 1.1 Property AddressThis section to be completed by office Map � G Let r ,;l, Unit 37 Fair Street zone Overlay District Elm SL District CB District SECTION 2-PROPERTY OWNERSHIP/AUTHORIZED AGENT 2.1 Owner of Record: Steve Kamey 37 Fair St,Northampton,MA 01060 Name(Print) Current Mailing Address: 401-265-3916 ` gp4'wi _. Telephone Signature 2.2 Authorized Agent: Name(Print) Current Mailing Address: Signature Telephone SECTION 3-ESTIMATED CONSTRUCTION COSTS Item Estimated Cost(Dollars)to be Official Use Only completed by pemnitapplicant 1. Building 34,360 (a)Building Permit Fee 2. Electrical 4,400 (b)Estimated Total Cost of Construction from 6 3. Plumbing 6,700 Building Permit Fee 4. Mechanical(HVAC) 5. Fire Protection 0 6. Total=(1 +2+3+4+ 5) 45,460 1 Check Number This Section For Official Use Only Building Permit Number: Date Issued: Signature: 4Ae Building Commi ;f?nadInsm mor of Buildings Date Cam I ra- ox�Dwde! t&16 1d. cowl e EMAIL ADDRESS (REQUIRED; EITHER HOMEOWNER OR CONTRACTOR) Section 4. ZONING All Information Must Be Completed.Permit Can Be Denied Due To Incomplete Information Existing Proposed Required by Zoning This column to be tilled in by Building Department Lot size .486 acres .486 acres Frontage 125' 125' Setbacks Front 20' 20' Side L:22' R: 72' L:22' R:72' Rear 120' 120' Building Height Bldg. Square Footage 1090 % 1090 Open Space Footage (lot area minus bldg&paved run ) #ofPuking Spaces Fill: (volume&Location) A. Has a Special Permit/Variance/Finding ever been issued for/on the site? NO © DONT KNOW e YES IF YES, date issued: IF YES: Was the permit recorded at the Registry of Deeds? NO © DONT KNOW O YES O IF YES: enter Book Page and/or Document# B. Does the site contain a brook, body of water or wetlands? NO O DONT KNOW © YES O IF YES, has a permit been or need to be obtained from the Conservation Commission? Needs to be obtained O Obtained 4 , Date Issued: C. Do any signs exist on the property? YES O NO e IF YES, describe size, type and location: D. Are there any proposed changes to or additions of signs intended for the property? YES O NO O IF YES, describe size, type and location: E. Will the construction activity disturb(Gearing,grading,excavation,or filling)over 1 acre or is it pan of a common plan that will disturb over 1 acre? YES O NO e IF YES,then a Northampton Storm Water Management Permit from the DPW is required. SECTION S DESCRIPTION OF PROPOSED WORK(check all applicable) New House ❑ Addition ❑ Replacement Windows Alteration(s) O✓ Roofing 0r Doors Accessory Bldg. ❑ Demolition ❑ New Signs [O] Decks ]p Siding[O] Other[C7J Brief Description of Proposed Remodel of master baduoom,replacemem of Gout door,replaccmem of 2 mdcwindows,Installation of new vinyl siding. Work: Alteration of existing bedroom_Yes X No Adding new bedroom Yes X No Attached Nartative Renovating unfinished basement Yes x No Plans Attached Roll -She ea. U New house and or addition to existing housing, complete the following: a. Use of building : One Family Two Family Other b. Number of rooms in each family unit: Number of Bathrooms c. Is there a garage attached? d. Proposed Square footage of new construction. Dimensions e. Number of stories? f. Method of heating? Fireplaces or Woodstoves Number of each g. Energy Conservation Compliance. Masscheck Energy Compliance form attachedi h. Type of construction I. Is construction within 100 ft.of wetlands? Yes No. Is construction within 100 yr. floodplain Yes No j. Depth of basement or cellar floor below finished grade k. Will building conform to the Building and Zoning regulations? Yes No. I. Septic Tank City Sewer Private well City water Supply SECTION 7a-OWNER AUTHORIZATION-TO BE COMPLETED WHEN OWNERS AGENT OR CONTRACTOR APPLIES FOR BUILDING PERMIT I, � a'" I ,as Owner of the subject property /n / I hereby authorize / G,v to act on my behalf, all matters relative to work authorized by this building permit application. SignaNre Owner / I A /�q/�_ Date as OwnerlAuthorized Agent hereby declare that the statements and information on the foregoing application are true and accurate,to the best of my knowledge and belief. Signed//u der the plaints and penalties of perjury. Print Name ld a-- Signature of ent Date SECTION 8-CONSTRUCTION SERVICES 8.1 Licensed Construction Supervisor: Not Applicable ❑ Name of License Holder: Carl Woodruff License Number 30 Pine Street, Easthampton, MA 01027 CS-109983 Address/ Expiration Date 03/03/2020 Signatu7' Telephone 413-527-9000 9.Realstered Home Improvement Comractcr: Not Applicable 0 Company Name Registration Number � I 77 186013 xboN _Drs % Address - rrr Expiration Date f2t[asanj S� SIe 109 E0.511fa /--,Telephone 1113 qO-'IJ 09/20/2018 SECTION ta-WORKERS' COMPENSATION INSURANCE AFFIDAVIT(M.G.L.c. 152,§25CS Workers Compensation Insurance affidavit must be completed and submitted with this application.Failure to provide this affidavit vnll result in the denial of the issuance of the 6uildin permit. Signed Affidavit Attached Vas....... No...... 0 City of Northampton Massachusetts UBPMTNBNT OF BUILDING INSPNCTIOrIS _ 212 Main Street • Municipal Building �F a \\ Northa ton, MA 01060 ryji. `qJ` AFFIDAVIT Home Improvement Contractor Law Supplement to Permit Application The Office of Consumer Affairs and Business Regulation("OCABR")regulates the registration of contractors and subcontractors performing improvements or renovations on detached one to four family homes. Prior to performing work on such homes,a contractor must be registered as a Home Improvement Contractor("HIC"). M.G.L. Chapter 142A requires that the"reconstruction, alteration, renovation, repair, modernization, conversion, improvement removal, demolition, or construction of an addition to any pre-existing owneroccupied building containing at least one but not more than four dwelling units....or to structures which are adjacent to such residence or building"be done by registered contractors. Note:7f the homeowner has contracted with a corporation or LLC,that entity mum �r be registered TypeofWork: hIMWJ Est. Cost:✓t ; t/40 r Address of Work: yj7 (•-wr,ST Va✓J� anr,of//ck7 Date of Permit Application: I hereby certify that: Registration is not required for the following reason(s): —Work excluded by law(explain): —Job under b 1,000.00 _Owner obtaining own permit(explain): _Building not owner-occupied Other (specify): OWNERS OBTAINING THEIR OWN PERMIT OR ENTERING INTO CONTRACTS WITH UNREGISTERED CONTRACTORS OR SUBCONTRACTORS FOR APPLICABLE HOME IMPROVEMENT WORK ARE NOT ELIGIBLE FOR AND DO NOT HAVE ACCESS TO THE ARBITRATION PROGRAM OR GUARANTY FUND UNDER M.G.L.Chapter 142A.SUCH OWNERS ALSO ASSUME THE RESPONSIBILITES FOR ALL WORK PERFORMED UNDER THE BUILDING PERMIT.SEE NEXT PAGE.FOR MORE INFORMATION. Signed under the penalties of perjury: I hereby apply for a building permit as the agent of the owner:it Date Contractor Name HIC Registration No. OR: Notwithstanding the above notice, 1 hereby apply for a building permit as the owner of the above property: Date Owner Name and Signature City of Northampton .A MassachusettsU ?' ° I DEPAATNENT OF BUILDING INSPECTIONS 212 Hain Street -Municipal BuildingNorthaapton, MA 01060 Debris Disposal Affidavit In accordance of the provisions of MGL c 40, S54, I acknowledge that as a condition of the building permit all debris resulting from the construction activity governed by this Building Permit shall be disposed of in a properly licensed solid waste disposal facility, as defined by MGL c 111, S 150A. The debris from construction work being performed at: 37 FG,, 4 (Please print house number and street name) Is to be 11disposed of at: (� AIIYYNaI iVC II LC tyC llti'I� (Please pant name and locat o�h of facility) Or will be disposed of in a dumpster onsite rented or leased from: (Company Name and Address) Signatur A pli nfof Owner Date If, for any reason, the debris will not be disposed of as indicated, the Applicant or Owner shall notify the Building Department as to the location where the debris will be disposed. the Commonwealth of massaenusetts Department of Industrial Accidents Office of Investigations 600 Washington Street Boston,MA 02111 www.moss.gov/dia Workers' Compensation Insurance Affidavit: Builders/Contractors/Electricians/Plumbers Applicant Information Please Print Legibly Name(Business/OrgmizahoNtndividual): �oW �t51gh 'jvi'p� Address: I22 Pjfttso,nt s{ SIe I0`1 r City/State/Zip: - AawlAc� GULF" Phonek 413 S23�crA Are ou an employer?Check the appropriate box: Type of project(required): I 1 am a employer with t 4. ❑ I am a general contractor and 1 6. ❑New construction employees(full and/or part-time).* have hired the sub-contractors r-�� 2.El am a sale proprietor or partner- listed on the attached sheet.t 7. [a,Remodeling ship and have no employees These sub-contractors have S. ❑ Demolition working for me in any capacity. workers' comp. insurance. q ❑ Building addition [No workers' comp. insurance 5. ❑ We are a corporation and its required.] officers have exercised their 10.❑Electrical repairs or additions 3.E:] 1 am a homeowner doing all work right of exemption per MGL I1.❑Plumbing repairs or additions myself. [No workers'comp. c. 152, §1(4),and we have no 12.❑Roof repents; insurance required.]` employees. [No workers' 13.❑ Other comp. insurance required.] 'Any...beam that checks box#1 mut also fll ouv the seeinn below showing chap workers'wmpensahon policy iutortrutloa ,Homeowners who submit do,aflirlo a maho ring they are doing all work and then hure outside contmcturs over submit a new aHldava indicating such, rContmctors that check rhis bar must arched an additional sheet showing the come of the sub-contractors and then workers'comp policy information. lam an employer that is providing workers'compensation insurance for my employees. Below is the policy and job site information. Insurance Company Nani/'-RUE/ 5 Policy#or Sclf-ins.Lic.#: (e5t/p12U17 'Q G -(a- Expiration Datc: 7/21/[T lob Site Address:_57 Fatly yl City/State/Zip: cv L'I col w 6167-� Attach a copy of the workers' compensation policy declaration page(showing the policy number and expiration date). Failure to secure coverage as required under Section 25A of MGL c. 152 can lead to the imposition of criminal penalties of a fine up to$1,500.00 and/or one-year imprisonment,as well as civil penalties in the form of a STOP WORK ORDER and a fine of up to$250.00 a day against the violator. Be advised that a copy of this statement may be forwarded to the Office of Investigations of the DIA for insurance coverage verification. 7 do hereby certify under the it and penaides ofperiury that the information provided above is none and correct Signature — Date' t/�$ Phone#: "!/3 Sz3' 9ax7 Official use only. Do not write in this area,to be completed by city or town official City or Town: Permit/Liceme# Issuing Authority(circle one): 1.Board of Health 2.Building Department 3.City Town Clerk 4.Electrical Inspector 5.Plumbing Inspector 6.Other Contact Person: Phone#: I STORAGE kL0WW,,'oALLlj' 0 CBATHROOM I O y I GH. I Q EXISTING SECOND FLOOR PLAN 714°= Y-0" Al z STORAGE I F34.41d W RAIL BY LAUNDRY OTHERS HOOK-UPS EXISTING 5'-7° D LOW WALL I I DN 201 301•W VANITY1PROVIDE ADJUST LENGTH I @ATOM FILL®RTOF EX'G BASEBOARD HEAT 6 LVTI TILE WAIN- n FLQORING z� SCOT:TBD (FULL HT. 61/2" F ILE Y io POSSIB�.E II �•RECESSED CCESSHELVES ANEL FUR OUT WALL O E D 2-4" BEHIND TUB 31/2" 2'-9" 2'-3" LOW WALL MATCH WINDOWSILL HEIGHT S CAP IS CONTINUOUS 2 PROPOSED SECOND FLOOR PLAN 114"= V-0" LOCATION TBD �IRONWG BOARD MATCH WIN BILL HEKNIT SO CAP IS CONTINUOUS d. R iq TEMPRED an GLASS REOD I ='C FEEDS FOR �P I tSS1JJri LAUNDRY '* ACCESS — I O MACHINES PANEL REQ'D � M TILE AT END OF TUB:AKER SBA-32W SHORT WALL 15'-1" -'r SL GFCI STAIR BELOW 3 I AlSLOPED CEBING FUTURE ABOVE ACCESS F BASEBOARD L TILE Teo TILE WAIN- BATHROOM SCOT:TBD I I TFF Ij� _ s I RE TUB FEED FOR FIR OUT WALL 3 1X BEHIND TUB JETTED TUB WITH HEATER 3a 2ND FLOOR ELEVATIONS 5 SECOND FLOOR ELECTRIC PLAN 114"= T-D" 1/4" = O' At AA 2 I 3 8 TILE WAIN- SCOT:TSD MIRROR TO SLOPED CEILING Q BE DETERMINED SCONCE FIXTURES 0 / / a 0 7 N Q i7 W LJ L� �I N 7.6• 4• ADJUSTED BB HEAT 3 SECOND FLOOR ELEVATIONS jC 1/4"= V-0" Ai NOTE: ELECTRIC KEY SPECIAL OUTLETS ONLY SHOWN:OTHERS MAY BE REQUIRED TO CONFORM TO CODE. SURFACE FIXTURE DUPLEX RECEPTACLE F s L FAN/LIGHT FIXTURE RECESSED FIXTURE o 220 V RECEPTACLE A PENDANT FIXTURE O SMOKE/CO DETECTOR Q-i SCONCE FIXTURE SWITCH I LOW-VOLTAGE UNDERCABINET *3 THREE-WAY SWITCH FIXTURE A